Old Faithful

We met by coincidence at Old Faithful, the geyser that is so predictable in a National Park known for unpredictable events like blizzards in August. This particular day was in October, cool with bluebird skies and fluffy clouds, patches of snow in the shadows, a remembrance of summer and a promise of winter.

“It must be great to be a neurosurgeon,” she said to me. “Everybody always knows you’re smart.”

She is easily three decades younger than me, beautiful, brilliant, charming, with a great job, a handsome husband and an adorable toddler. The question surprises me. I know it is more about her than me. I hear years of frustration at not being heard, not being appreciated, her voice, probably the smartest in the room, frequently being drowned out by “man talk.”

I don’t really know how to answer her so I laugh it off. I tell her that’s it so much worse these days. Now when I do something dumb, people shake their heads and say, “He used to be a neurosurgeon. So sad.”

She laughed, I laughed. But it made me wonder about what being smart had to do with being a neurosurgeon.

To be honest, being seen as smart was something that was important to me back when I was a teen-ager. But what I really wanted was what Holden Caulfield wanted: to be the catcher in the rye, the one who caught children playing in the fields before they fell off the cliff.  A meaningful life meant saving lives.

But saving lives is an illusion. By medical school I realized what should have been obvious from the first: Lives are never saved; only prolonged.

I learned to imagine death as a large predatory cat–a lion, a tiger, a jaguar, or a black panther–something sinister and lurking somewhere behind my left shoulder, and everyone has his own big cat lurking behind his own left shoulder. He (and it always is a he) waits for a chance to pounce, and my job became to recognize when this creature is about to leap, then run between him and his prey, shoo him off, make him wait.

Because he only waits. He never goes away. In the end, he will have his prey. A complete win sends the big cat into the bushes for years. A small win sends him away for only a few days. An attack leaves pain, disability, scars, fears, until the inevitable end. He is relentless.

What is it to run between the big cat and his prey? What’s it like to be the neurosurgeon?

It’s standing there when the beautiful young woman with the winning smile and the great mind who can write poetry and play music and draw pictures and run with the wind comes into the ER because she has bled in her brain and can no longer smile, can no longer think, can no longer use her right hand and can no longer run or even walk. And she will die in a few minutes unless just the right things are done in just the right order and done right now. It’s standing in the OR an hour later carefully sucking blood clots out of a damaged brain wondering about the smile, the hand, the leg, and even the piano lessons, and wondering if they will be okay, but not worrying too much about that now because something caused the bleed, something like an AVM or an aneurysm, something that I know is there but don’t know what or where because there was no time to find out if she was to have more time in this life, and any moment whatever it is can explode and bleed again and maybe this time it won’t stop. It’s looking through an operating microscope for the next three hours dissecting arteries, ligating bad ones and saving good ones–they all look so much alike even under the microscope. And one mistake will lead to a lost smile, a lost hand, a lost leg, a lost mind, or even the end of time for her if I, or the cadre of techs and nurses and doctors that hold me up, make that one mistake. Then the big cat does not run back into the jungle, and her time is up.

And when it is over and all the blood is gone and all the arteries are open and there is no more aneurysm or AVM, I do not fist pump like Tiger Woods or knee slide like Mia Hamm or flip my bat while jogging around the bases like Babe Ruth. When it is over, I say Thank you Jesus and feel not triumph but only a cautious relief because the big cat has slunk off for now but I know he is still nearby, still waiting to pounce; the game is not over. The game is never over.

But, yes. Everyone thinks I’m smart.

I’m tempted to lapse into a Ecclesiastes theme: Vanity, vanity, all is vanity. It doesn’t matter if people think you’re smart. There is nothing new under the sun. People have always gotten sick, healers have always fought the losing battle against disability and death. From ashes we come, to ashes we return. All of which is true, of course, but a thin and obvious truth. It’s where Solomon started his book, not where he finished.

There is a time, he said, for all seasons–to be born and die, to kill and heal, to weep and laugh, to make war and to make peace. And this is the profound truth: Time is our gift. We have time for all the moments of our lives that gives us windows into eternity–birth and death, weeping and laughter, war and peace–because there is One who is even older and more faithful than the geyser by the same name, and He cares about the days of our lives.

She returned to her husband and son; they are expecting another child soon. I returned to my wife; we are expecting another grandchild soon. There is a time to be born. Together we all walked to the geyser basin to see it erupt again. Right on time.